代谢综合征、抑郁及性激素水平对银屑病患者勃起功能障碍的影响

目的:观察银屑病患者发生勃起功能障碍(ED)的一般情况,研究代谢综合征、抑郁、血浆睾酮水平与银屑病患者发生ED的相关性。方法:用国际勃起功能评分表(IIEF-5)对57例银屑病患者及79例正常男性性功能进行评价,并用抑郁自评量表(CES-D)对参与者抑郁情绪进行评价。同时记录参与者的年龄、身高、体重、血压、血脂、血糖、血清睾酮。结果:IIEF-5评分结果显示57例银屑病患者中30例(52.6%)有ED,79例正常男性中29例(36.7%)有ED。年龄校正的结果显示银屑病组发生ED比例较高,OR值为2.29(95%CI 1.06~4.98)。单因素分析结果显示银屑病患者年龄、代谢综合征、抑郁症是ED发生的危险因素;多因素分析结果显示抑郁症是ED发生的独立危险因素。结论:银屑病患者ED发生率较高,银屑病患者ED的调查可以作为一项临床常规开展项目。     

寻常性银屑病患者并发代谢综合征影响因素的Logistic回归分析

目的探讨寻常性银屑病患者发生代谢综合征的相关影响因素。方法对202例确诊为寻常性银屑病的门诊患者进行问卷调查、体格及实验室检查,对寻常性银屑病患者发生代谢综合征的相关因素进行Logistic回归分析。结果年龄大、A型性格、不吃早餐、饮酒是寻常性银屑病患者并发代谢综合征的独立危险因素。结论积极调整患者心态,减轻精神压力,改善生活方式,可望降低和预防寻常性银屑病患者代谢综合征的发生。     

阿达木单抗治疗斑块型银屑病疗效及代谢综合征对疗效的影响

目的:明确阿达木单抗治疗斑块型银屑病患者的疗效.方法:收集2020年9月至2021年3月经阿达木单抗治疗的斑块型银屑病患者,分析经阿达木单抗治疗0、4、8、12周的PASI评分变化及相关性.结果:共收集20例患者,其中1例中断治疗,19例患者中伴和不伴代谢综合征患者分别为11例和8例.经阿达木单抗治疗12周后,19例患...     

代谢综合征对IVF/ICSI-ET助孕结局影响的临床观察

目的：探讨代谢综合征与IVF-ET/ICSI过程及结局的关系.方法：回顾性分析从2009年1月至2013年3月于我院行长方案IVF或ICSI-ET辅助助孕患者共145个周期,所有患者在进入助孕周期前均未对代谢综合征进行预处理,按照WHO制定的亚洲成人BMI标准[1]的不同分为三组：A组（正常组,18.5 kg/m2≤BMI ＜23 kg/m2）、B组（超重组,23 kg/m2≤BMI＜ 25 kg/m2）、C组（肥胖组,BMI≥25 kg/m2）;又根据2005年国际糖尿病联盟（IDF,2005年）[3]制定的代谢综合征标准降B、C各分为两组：B1组（超重非代谢综合征组）,B2组（超重代谢综合征组）,C1组（肥胖非代谢综合征组）,C2组（肥胖代谢综合征组）;比较各组患者一般情况、治疗情况及妊娠结局.结果：（1）基础情况：BMI值及腹围A、B、C三组差异显著（P＜0.01）.（2）治疗情况：Gn用量C2组均稍高于其他各组（P＜0.05）;HCG日E2值及MII期卵细胞数：B2、C2组均显著低于A组（P＜0.01）;获卵数,胚胎数B2、C1、C2组均低于A组（P＜0.05）;优质胚胎数C2组显著少于A组（P＜0.01）.（3）妊娠结局：胚胎种植率、临床妊娠率A、B1、C1组均显著高于B2及C2组（P＜0.01）;不良妊娠率B2、C2组显著高于A组（P＜0.01）,B2、C2组的不良妊娠率高于B1、C1组,但无统计学意义（P＞0.05）.结论：代谢综合征可能通过降低卵巢反应及内膜容受性来对患者产生不良影响.接受ART治疗的代谢综合征超重及肥胖患者妊娠结局明显差于正常体重患者,但超重及肥胖未伴代谢综合征的患者和正常体重患者的妊娠结局并不明显.     

医学营养指导联合运动疗法对肥胖型多囊卵巢综合征患者糖脂代谢和胰岛素抵抗水平的影响

目的 基于限能量平衡膳食的医学营养指导联合运动疗法对肥胖型多囊卵巢综合征(PCOS)患者糖脂代谢和胰岛素抵抗水平的影响.方法 选取2017年4月至2018年4月北京市垂杨柳医院诊治的90例肥胖型PCOS患者作为研究对象.按照数字随机原则分成两组,对照组(n=45)采用盐酸二甲双胍缓释片和艾塞那肽注射液治疗3个月,观察组...     

慢性非传染性疾病对老年与非老年急性脑梗死患者发生多器官功能不全综合征的影响对照研究

目的分析慢性非传染性疾病对急性脑梗死患者发生多器官功能不全综合征（MODS）的影响。方法将864例急性脑梗死患者分为两组：老年组（n=594）[平均年龄（71．39±6．70）岁（60-94岁）]，和非老年组（n=270）[年龄（49．58±8．34）岁（18-59岁）]。老年组发生MODS154例（25．9％），非老年组发生MODS39例（14．4％）。将可能对急性脑梗死患者MODS的发生产生影响的慢性非传染性疾病进行多因素Logistic回归分析，寻找其中的危险因素。结果在老年组，慢性非传染性疾病中糖尿病、高血压、心血管慢性病、呼吸系统慢性病、肾脏慢性病是急性脑梗死患者多器官功能不全综合征发生的主要危险因素；在非老年组，高血压、心血管慢性病是主要危险因素。结论老年组的慢性基础病和多器官功能衰竭的发生率高于非老年组。不同年龄组的脑梗死患者发生MODS的主要危险因素不完全相同。     

非那司提联合坦洛新应用于非细菌性前列腺炎患者的临床效果及对性功能的影响研究

目的:探讨非那司提联合坦洛新治疗非细菌性前列腺炎的临床效果以及对性功能的影响,提高患者的生活质量。方法:选择2015年3月至2017年2月在华北理工大学附属医院接受药物治疗的非细菌性前列腺炎患者104例,将其随机分为对照组和观察组,每组52例。对照组患者给予盐酸坦洛新口服,观察组患者在对照组基础上给予非那司提口服。对两组患者的临床症状进行评估,对治疗效果和治疗前后性功能、尿动力学进行评价。结果:观察组患者治疗总有效率高达98. 1%,对照组患者总有效率为86. 5%,两组差异具有统计学意义(P <0. 05);两组患者治疗前CPSI、IIEF-5、MFR和RVU比较,其差异均无统计学意义(均P> 0. 05);两组患者治疗后CPSI得分和RVU均有所降低,IIEF-5得分和MFR均有所升高,但观察组CPSI得分和RVU低于对照组,MFR高于对照组,两组差异均有统计学意义(均P <0. 05);两组患者IIEF-5得分差别不大,其差异无统计学意义(P> 0. 05)。结论:非那司提联合坦洛新治疗非细菌性前列腺炎可以有效改善患者的临床症状和性功能,与单纯使用坦洛新相比可以获得更好的治疗效果。     

窄谱中波紫外线联合吡美莫司乳膏对成人型特应性皮炎患者PBMC产生eotaxin和CCR3表达的影响

 目的:检测窄谱中波紫外线（NB-UVB)联合吡美莫司乳膏治疗前后,特应性皮炎 (AD) 患者外周血嗜酸性粒细胞活化趋化因子(eotaxin)与其相应受体CCR3的表达,以探讨其治疗特应性皮炎的相关机制。方法: 采用窄谱中波紫外线联合吡美莫司乳膏治疗30例成人型AD患者,酶联免疫吸附试验检测治疗前后血清中eotaxin水平; 同时用流式细胞仪分析外周血中CCR3的表达。结果: 治疗前,AD患者血清eotaxin水平为(133.86±42.23) pg/mL,CCR3表达水平为(23.10±6.31)%;治疗后,AD患者血清eotaxin水平为(101.54±35.63) pg/mL,较治疗前明显降低(t=3.20,P＜0.01);外周血 CCR3表达水平为(16.52±6.59)%,较治疗前亦明显降低(t=3.59,P＜0.01)。结论: 窄谱中波紫外线联合吡美莫司乳膏可能通过降低eotaxin、CCR3表达,从而减少嗜酸性粒细胞的募集、活化,发挥其治疗特应性皮炎的作用。     

克龄蒙联合定坤丹对更年期综合征患者性激素及更年期症状的影响

目的探讨克龄蒙联合定坤丹对更年期综合征患者康复效果的影响。方法选取2017年3月至2019年3月唐山市人民医院收治的96例更年期综合征患者作为研究对象。随机将其分为观察组(n=48)和对照组(n=48)。对照组仅予以克龄蒙治疗,观察组在对照组基础上联合定坤丹治疗,比较两组性激素水平、氧化应激反应及更年期症状改善情况、平均子宫内膜厚度、临床治疗总有效率。结果治疗后,两组性激素水平中LH、FSH均降低,P均升高,氧化应激指标中MDA水平均降低,SOD水平均升高,且观察组变化幅度大于对照组,差异具有统计学意义(P<0.05);观察组各更年期症状评分均低于对照组,差异具有统计学意义(P<0.05);观察组平均子宫内膜厚度及治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。结论将克龄蒙联合定坤丹用于更年期综合征患者治疗中,能够有效帮助患者改善性激素水平、氧化应激反应及相关更年期症状等,临床疗效确切。     

糖皮质激素联合氯米芬治疗多囊卵巢综合征对患者血清孕酮、雌二醇的影响分析

目的:分析糖皮质激素与氯米芬合用治疗多囊卵巢综合征对患者血清孕酮、雌二醇的影响。方法:选取2015年1月至2016年3月在我院生殖科诊断为多囊卵巢综合征的患者共120例,随机均分为两组,每组60例。对照组仅给予氯米芬治疗,观察组加服糖皮质激素治疗。比较两组治疗效果;检测两组患者成熟卵泡数、子宫内膜厚度、注射HCG日血清E_2值,对宫颈粘液进行评分;检测两组患者治疗前后的生殖内分泌指标水平,包括卵泡刺激素(FSH)、黄体生成素(LH)、孕酮(P)、雌二醇(E_2)、睾酮(T)、泌乳素(PRL)、性激素结合蛋白(SHBG)。结果:观察组总有效率96.67%,显著大于对照组的81.67%(P0.05);观察组HCG日血清E_2水平、子宫内膜厚度、成熟卵泡数、宫颈粘液评分均显著优于对照组(P0.05);观察组FSH、LH、E_2、T、PRL水平明显降低(P0.05),P、SHBG水平明显升高;两组比较有统计学差异(P0.05)。结论:糖皮质激素与氯米芬合用治疗多囊卵巢综合征可有效改善患者激素水平。     

银屑病合并代谢综合征的研究进展

银屑病合并代谢综合征日益增多.相同的炎症过程,遗传和环境因素可能是导致两种疾病并存的原因,银屑病增加代谢综合征的发病风险,治疗同时可降低代谢综合征的发病危险,针对代谢综合征的综合治疗有助于银屑病皮损的改善.为有效治疗和管理银屑病,需认清其与代谢综合征之间的关联,探讨更新的治疗标准,并采取多学科合作的综合治疗方式.     

银屑病与代谢综合征发病机制的研究进展

银屑病和代谢综合征是两种临床常见病,可合并出现.银屑病是慢性复发性炎症性多因素皮肤病,发病与遗传、免疫,感染、吸烟以及精神紧张等因素有关.代谢综合征以中心性肥胖为核心,合并高血糖、高血压和脂代谢紊乱等多种代谢异常集结的病理状态.银屑病与代谢综合征发病机制密切相关,且存在共同的细胞因子表达.对代谢综合征的研究可以为银屑病的治疗提供新的靶位.     

76例寻常型银屑病患者伴代谢综合征的临床研究

目的探讨寻常型银屑病及其严重程度与代谢综合征(MS)及其各项指标的关系。方法选取符合标准的寻常型银屑病患者和健康体检者,各76例分别作为观察组和对照组。检测所有受试者的甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、空腹血糖(FPG),测量身高、体重、收缩压(SBP)、舒张压(DBP),计算观察组银屑病皮损面积及严重度指数(PASI)。比较两组PASI10与PASI≤10患者MS发病情况以及其相关指标的差异。结果观察组MS患病率为32.9%,对照组MS患病率为10.5%,前者高于后者,差异有统计学意义(P0.05);观察组BMI、FPG分别为(25.24±3.60)kg/m~2、(6.13±1.21)mmol/L明显高于对照组(22.94±3.05)kg/m~2、(5.32±1.07)mmol/L;而SBP、DBP、TG、HDL-C两组间相比差异无统计学意义;比较PASI10与PASI≤10的MS患病率、BMI、FPG、SBP、DBP、TG、HDL-C平均水平,差异无统计学意义。结论寻常型银屑病患者中MS的患病率较高,且MS相关生化指标与普通人群相比有不同程度的差异。     

Higher incidence of metabolic syndrome components in vitiligo patients: a prospective cross-sectional study

Background/ObjectivesTo investigate the association between vitiligo and metabolic syndrome.MethodsA prospective cross-sectional study was conducted between 2014 and 2016. Study (n = 155) and control groups (n = 155) were evaluated for metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation criteria. Study group was divided into three groups according to their vitiligo area severity index and vitiligo disease activity score values (Group 1: 6.89 for VASI score, Group A: −1–0, Group B: 1–2 and Group C: 3–4 for vitiligo disease activity score respectively). MetS rates according to both criteria were compared between the vitiligo disease activity score and vitiligo area severity index groups.ResultsMetabolic syndrome rates were 37.4% and 40% in the study group and 19.4% and 26.5% in the control group according to National CholesterolEducation Program Adult Treatment Panel III and International Diabetes Federation criteria, respectively (p < 001 and p = 0.011). Metabolic syndrome was more frequent in vitiligo area severity index Groups 2 and 3 compared to vitiligo area severity index Group 1, and in vitiligo disease activity score Group C compared to vitiligo disease activity score Groups A and B.Study limitationsSingle center experience, absence of more specific oxidative-stress markers and lack of long-term follow-up of the patients.ConclusionsFrequency of metabolic syndrome was higher in patients with non-segmental vitiligo and the rate was higher in active/severe form of the disease.     

缺血性脑血管疾病与代谢综合征及颈动脉粥样硬化的关系

目的探讨颈动脉粥样硬化及代谢综合征与缺血性脑血管疾病发生的关系。方法357例缺血性脑血管病患者（短暂脑缺血发作109例,脑梗死248例）,接受颈动脉血管超声、体重、腹围、血脂、血糖、血压、吸烟状况、心脏情况等检查。以非条件Logistic回归分析动脉粥样硬化、代谢综合征、高血压、糖尿病、高脂血症等因素间的相关性。结果①89．1％（318／357）患者存在颈动脉粥样硬化。26．9％（96／357）患者存在颈动脉中重度狭窄,其中短暂脑缺血组颈动脉中重度狭窄的比例为43．1％（47／109）,高于脑梗死组（19．8％,49／248,P〈0．01）。②糖尿病、高血压、高血脂、代谢综合征与颈动脉粥样硬化有明显相关性（均P〈0．01）,代谢综合征患者颈部动脉狭窄率达41．9％,显著高于糖尿病、高血压、高血脂组（分别为26．4％,28．9％,及24．4％,均P〈0．01）。结论颈动脉粥样硬化与缺血性脑血管疾病的发生显著相关,代谢综合征与颈动脉血管狭窄显著相关。控制高血压、糖尿病、高血脂及代谢综合征对预防缺血性脑血管疾病的发生意义重大。     

夜间阴茎勃起功能监测结果与代谢综合征的相关性研究

目的:研究夜间阴茎勃起功能检测结果与代谢综合征的相关性分析。方法:对黑龙江省牡丹江医学院第二附属医院2012年5月至2014年5月间636例男性夜间阴茎勃起功能进行监测,根据其有无代谢综合征将其分为两组,所有患者均需要依据国际勃起功能指数(IIEF-5)填写问卷,代谢综合征(MS)的诊断标准依据2005年国际糖尿病联盟颁布的国际学术界第一个MS的全球统一定义,这一定义的核心是中心性肥胖,中心性肥胖的诊断指标为腰围。结果:观察组的116名被调查者为存在代谢综合征的患者,IIEF-5为(12.7±3.6)分,有76%的患者存在程度不等的夜间阴茎勃起功能障碍;对照组的520名被调查者为不存在代谢综合征患者,IIEF-5为(19.8±2.8)分,有43%的患者存在程度不等的夜间阴茎勃起功能障碍;两组患者ED发生率差异显著(P0.05),且随着代谢危险因素的不断提升,勃起功能评分明显下降。结论:夜间阴茎勃起功能障碍中存在的潜在危险因素为代谢综合征,对于代谢综合征就诊的患者应认真询问阴茎勃起功能障碍的病史,可将腰围测量纳入评价中的一个指标。     

Pediatric androgenetic alopecia: a retrospective review of clinical characteristics,hormonal assays and metabolic syndrome risk factors in 23 patients

BackgroundAndrogenetic alopecia in the pediatric population is rarely discussed in the literature. Although the prevalence of the metabolic syndrome is increased in patients with early-onset androgenetic alopecia, the presence of metabolic syndrome risk factors in pediatric androgenetic alopecia is unknown.ObjectiveTo evaluate the demographics, medical and family histories, clinical and trichoscopic features, androgenic hormones, and metabolic syndrome risk factors in pediatric androgenetic alopecia.MethodsThe medical reports of pediatric patients with androgenetic alopecia were reviewed.ResultsThe study included 23 patients (12 females and 11 males) with a mean age of 15,3 ± 2,1 years. Sixteen patients had adolescent androgenetic alopecia and seven, had childhood alopecia. Nine patients reported a family history, all of whom had adolescent androgenetic alopecia. Hyperandrogenism was noted in three patients with adolescent androgenetic alopecia. The most common hair loss pattern was diffuse thinning at the crown with preservation of the frontal hairline which was noted in 10 patients (43.5%), six of whom were males. Fourteen patients (60.9%) had at least one metabolic syndrome risk factor. The most common risk factor was obesity or overweight (47.8%) followed by insulin resistance (21.7%), high fasting blood glucose (13%), high blood pressure (4.4%) and lipid abnormalities (4.4%).Study limitationsRetrospective study; lack of a control group.ConclusionPediatric androgenetic alopecia is often associated with metabolic syndrome risk factors. Therefore, androgenetic alopecia in the pediatric population may indicate a future metabolic syndrome which warrants an accurate and prompt diagnosis for early screening and treatment.     

Psoriasis and the metabolic syndrome

Psoriasis is an inflammatory, immune‐mediated cutaneous disorder that has recently been recognized as systemic disease that is associated with multiple comorbidities such as depression, obesity, and the metabolic syndrome. The metabolic syndrome is the constellation of abdominal obesity, dyslipidemia, hypertension and insulin resistance, and presence of the metabolic syndrome significantly increases a patient's risk for cardiovascular disease, stroke and type 2 diabetes. Recent studies have found that psoriasis patients are at increased risk for metabolic syndrome as well as the individual components of metabolic syndrome, and the two diseases appear linked through a common mechanism of inflammation. Speculation exists as to whether this association is causative or whether it is the result of other habits seen in psoriasis patients, such as increased rates of smoking, alcohol consumption, and sedentary lifestyle, which add to the complexity of the association between psoriasis and the metabolic syndrome. However, psoriasis treatments have been shown to reduce the risk of developing metabolic syndrome components and comorbidities. Future studies are needed to better understand the nature of this relationship and the implications this could have for management and treatment of patients with psoriasis.     

Functional and metabolic complications of androgen deprivation therapy

Prostate cancer is the most common non-cutaneous cancer in men worldwide.Several different treatment strategies are available including minimally invasive procedures for localized tumors such as radical prostatectomy,radiotherapy,and androgen deprivation therapy,among others.All these strategies can be given as mono-therapy or as combination therapy.For this review,we will focus on the side effects of androgen deprivation therapy,independent of the other treatment modalities.Some of the most common affections are loss of bone mineral density,weight gain and obesity,myocardial infarction and sudden death,metabolic syndrome and insulin resistance,dyslipidemia,loss of libido and erectile dysfunction,fatigue,cognitive decline,vasomotor flushing,to mention a few.All these alterations can have an impact on quality of life and even lead to more serious complications such as fractures and cardiovascular complications.We present recommendations for prevention,early recognition and treatment.The different modalities for androgen deprivation therapy have particular side-effects profiles and indications should be made in an individualized manner.Androgen deprivation therapy is a useful tool for some patients with prostate cancer but every effort should be made to avoid related complications.The use of guidelines and educational programs for both,patients and urologists,are extremely useful strategies.